NEW YORK (Reuters Health) - Mothers who
give birth in areas with higher concentrations of African-Americans are
less likely to get breastfeeding support on maternity wards than mothers
in other communities, a new study shows.

Breastfeeding provides well-documented health benefits to infants
and their mothers. But African-American women are about 16 percent
less likely to nurse their newborns than white women, according to
research from the Centers for Disease Control and Prevention (CDC).

The study of 2,727 American hospitals and birth centers sought to
uncover the reasons for the racial disparities.

“What this study suggests is that hospital practices, not just
women’s choices, beliefs or values, contribute to the observed
racial disparities in infant feeding,” sociologist Elizabeth
Armstrong told Reuters Health in an email.

“Where a woman lives – and consequently gives birth – affects how
her infant is nourished. Black babies and their mothers are less
likely to start off in environments that support the optimal level
of care for infant feeding and mother-baby bonding,” she said.

Armstrong, a professor at Princeton University in New Jersey, was
not involved in the current study.

The CDC researchers gathered data on optimal maternity care from
hospitals and birth centers across the U.S. and compared areas with
a higher percentage of black residents to areas with a lower
percentage.

Facilities in zip codes with more black residents were more likely
to give tests to their staff on breastfeeding support, the
researchers wrote in the CDC’s Morbidity and Mortality Weekly
Report.

At the same time, maternity wards in areas with more
African-Americans were less than half as likely to limit the use of
breastfeeding supplements, such as formula. A 2006 report from the
Government Accountability Office showed that when hospitals hand out
free formula samples, mothers tend to breastfeed less.

Hospitals in neighborhoods with more African-Americans were also 7
percent more likely to give newborns pacifiers, which can inhibit
breastfeeding.

And facilities in areas with higher concentrations of whites were
nearly 14 percent more likely to promote early initiation of
breastfeeding and nearly 12 percent more likely to work to keep
newborns next to their mothers in the hospital. Both factors are
known to promote breastfeeding.

Hospitals in neighborhoods with more blacks were significantly less
likely to offer breastfeeding support after mothers returned home.

“This study shows the best support is not where it’s most needed,”
Dr. Miriam Labbok told Reuters Health in a telephone interview. “If
we could just change the hospital practices, I think we could have a
lot more equity.”

A pediatrician, Labbok is the founding director of the Carolina
Global Breastfeeding Institute at the University of North Carolina
at Chapel Hill and was not involved in the current study.

Lead author Jennifer Lind told Reuters Health that it’s too early to
understand the reasons for the racial differences.

“Because this is the first stab or look into the whole issue, we
really don’t know why we’re seeing these disparities,” she said in a
telephone interview. Lind is an epidemiologist with the CDC.

“We found that hospital practices during childbirth have a major
impact on whether a mother is able to start and continue
breastfeeding,” she said. “We think it’s really important that all
hospitals – regardless of where they’re located – apply policies and
practices proven to be supportive of breastfeeding so that more
babies are able to reap the numerous benefits.”

Research has shown that breastfed babies, especially those fed just
breast milk without any formula, are less likely to die of sudden
infant death syndrome, or SIDS (see Reuters Health story of June 14,
2011 here: http://reut.rs/VPTRIv). African-American babies are more
likely to die from SIDS, also known as “crib death.”

Breastfeeding also lowers babies’ risk of infection, childhood
obesity, asthma and type 2 diabetes, Lind said. Mothers who nurse
their babies cut their chances of being diagnosed with breast and
ovarian cancer, she said.

The American Academy of Pediatrics recommends exclusive
breastfeeding for six months and continued breastfeeding for another
year while babies are introduced to complementary foods.

In 2011, 79 percent of new American mothers started to breastfeed
their infants, but fewer than half were still breastfeeding at six
months, according to the CDC.

Only 195 U.S. hospitals, accounting for 8 percent of all births,
have earned the status of Baby Friendly, the gold standard for
optimal maternity care established by the World Health Organization
and UNICEF in 1991, Armstrong said.

“I really think what we’re seeing here is very much due to the fact
that hospitals put up barriers,” Labbok said. “I’d say this is a
very good reflection of something that’s wrong, and it needs to be
fixed.”

She noted that African-American women continued to nurse their
babies at higher rates than white women in the 1960s, when
breastfeeding in the U.S. hit an all-time low.

“In general, there has been this incorrect assumption that because
you’re black, you don’t breastfeed, and that is just out and out
wrong,” Labbok said. “We’ve really got to strive for equity. This
study shows very clearly that we have some work to do.”